Parent-Child Class Application
Our program is open to expecting parents and children ages birth through 3 ½ years. There is a $25 application fee, you will be invoiced upon receipt of this application. Younger siblings are welcome to attend the class for an additional $50. All fields are required for application to be processed.
Child's Name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Gender
female
male
Other
Parent's name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 2
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address (if different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Sibling names and ages
How many adults will be attending the Parent-Child class?
What do you most hope to receive from this program?
Do you offer any screen time in your home? If so, how often each week?
Do you or your child have any known allergies or food intolerance?
Please tell us about the birth of your child:
Are there any special needs your child may have? Please note any special conditions such as physical emotional or developmental needs.
Please comment on your child’s likes and dislikes, disposition, special circumstances or experiences, fears, etc:
Which session(s) are you applying for?
Parent- Baby Classes (birth-18 month olds) Mondays 9:30 - 11:30
Welcome Spring: February 24th - March 30th
Spring April 20th - June 1st
Parent-Child Classes (birth to three years old) Wednesdays 9:30 - 11:30
Welcome Spring: February 26 - April 6th
Spring: April 15th - June 3rd
All fees and tuition must be paid in full prior to the first day of your session.
*
I agree
How did you hear about us?
*
AWS website
word of mouth
Mountain Xpress
Flyer around town
Social Media
Other
Submit
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